How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,238.72 Median $6,456.54 Typical High $13,182.57 | Facility | None | $2,238.72 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $758.58 Typical High $758.58 | Professional | None | $426.58 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $562.34 | Professional | None | $416.87 | $489.78 | $562.34 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $23,988.33 Typical High $48,977.88 | Facility | None | $1,445.44 | $23,988.33 | $48,977.88 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $2,089.30 Typical High $2,089.30 | Professional | None | $416.87 | $2,089.30 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $707.95 | Professional | None | $398.11 | $407.38 | $707.95 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $346.74 Median $676.08 Typical High $1,698.24 | Professional | None | $346.74 | $676.08 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $707.95 | Professional | None | $239.88 | $407.38 | $707.95 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $213.80 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $85.11 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $316.23 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $63.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $42.66 | $75.86 | $75.86 |
Where New York sits
The same service costs 27.5 times more in Oklahoma than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 51st of 51
$525
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.